Mhealth hearing screening for children by non-specialist health workers in communities

Abstract

Objectives: To compare outcomes of a community-based hearing screening programme using smartphone screening audiometry operated by specialist (School Health Nurses–SHNs) and non-specialist health workers (Community Health Workers–CHWs) in school children. Design: This study used a two-group comparison of screening outcomes as conducted by SHNs and CHWs using smartphone screening for children in communities. Study sample: The study included 71 CHWs and 21 SHNs who conducted community-based hearing screening on 6805 children. One thousand one hundred and fifteen hearing screening tests were conducted by the CHWs and 5690 tests by the SHNs. Results: No significant difference in screening outcome was evident between CHWs and SHNs using a binomial logistic regression analysis considering age, test duration and noise levels as independent variables. Final screening result was significantly affected by age (p < 0.005), duration of test (p < 0.005) and noise levels exceeding at 1 kHz in at least one ear (p < 0.005). Test failure was associated with longer test duration (p < 0.005; B: 119.98; 95% CI: 112.65–127.30). CHWs had significantly (p < 0.005) longer test durations (68.70 s; 70 SD) in comparison to SHNs (55.85 s; 66.1 SD). Conclusion: Low-cost mobile technologies with automated testing facilitated from user-friendly interfaces allow minimally trained persons to provide community-based screening comparable to specialised personnel.